Objective To investigate the clinical efficacy of π-shaped plate combined with iliac autograft used in the treatment of comminuted distal radius fractures in the middle-aged. Methods Betwcen January 2005 and May 2008,21 cases of comminuted distal radius fractures in the middle-aged were treated with π-shaped plate combined with autograft.According to the AO/ASIF classification,there were 5cases of type A3,7 cases of type C2,and 9 cases of type C3.After operation their wrist joints were fixed at functional position with plaster brace and cast for an average of 6 weeks.The range of active motion of the wrist,the pre- and postoperative radiographic parameters,bone union,wound and the functional recovery of the wrist were observed and compared. Functional exercise was encouraged 6.2 months after fixation.Results All the patients were foHowed up for an average of 13.5 months.The average bone union time was 6 months.The average palmar tilt Was improved from preoperative-15° to postoperative 13.2°,the average ulnar variance was improved from preoperative 14.5° to postoperative 22.7°,and the average radioulnar relative length Was improved from preoperative -1.2 cm to postoperative 1.3 cm.No nonunion,screw loosening,broken plate,tendon rupture,or infection of the wounds was found in this series.The excellent to good rate Was 90.5% according to the rating SCale of Gartlant and Werely. Conclusion π-shaped plate combined with iliac autograft is a satisfactory technique for the treatment of comminuted distal radius fractures in the middle-aged. Key words: Radius fractures; Fracture fixation; internal; Bone transplantation; π-shaped plate